Primary health-care patients’ reasons for complaint-related worry and relief

Abstract

Primary care patients are commonly worried about their complaints when consulting their doctor. Knowing the reasons behind patients' worries would enhance consultation practices. The aim of this study was to find out the reasons patients themselves give for their worries before a consultation and for possible relief or persistent worry after the consultation. Our previous study using quantitative methods suggested that worried patients were uncertain about what was wrong with them and they perceived their complaints as serious. These results left some aspects unanswered; for instance, why did the patients consider their complaints severe. We conducted semi-structured interviews of patients, aged 18-39 years, with somatic complaints other than a common cold (n = 40), both before and after a consultation, and the patients described their reasons for worry in their own words. These qualitative data were analysed using thematic content analysis. The patients gave as reasons for their worries uncertainty, consequences of their complaints (eg, inability to work), insufficient control (eg, inadequate treatment) and prognosis. The patients were relieved when their uncertainty was diminished by getting an explanation for their complaint or when they achieved more control by getting treatment for their complaint. After a consultation, their reasons for worry, except for concern about the ability to function, tended to be replaced by other reasons. Psychological consequences and mistrust in health care also played a role in persistent worry. Our findings offer support to the patient-centred clinical method in primary care. To address the patients' worries properly, the GP should bring them up for discussion. Special attention should be given to worries about the ability to function, as they tend to persist even after a consultation.